Cardiopulmonary resuscitation (CPR) is one of the first emergency responses needed when an adult experiences sudden cardiac arrest. When the heart stops pumping blood effectively, the brain and other vital organs lose oxygen. Starting CPR immediately helps maintain blood flow and prevent further complications. However, you should follow the correct CPR steps to provide effective assistance when someone experiences sudden cardiac arrest.
This guide explains the 7 steps of adult CPR, the differences between CPR techniques, and common mistakes to avoid during an emergency.
What Is Adult CPR?
Adult CPR (Cardiopulmonary Resuscitation) is an emergency lifesaving procedure performed on adults aged 12 years and older who experience cardiac arrest. It combines chest compressions to pump blood through the body and rescue breaths to deliver oxygen to the lungs.
The procedure focuses on maintaining circulation through proper compression depth, rate, hand placement, and ventilation. These techniques help support brain and organ function during cardiac arrest and improve the person’s chances of survival.
What are the 7 steps of adult CPR?
The seven basic steps of adult CPR are:
- Check the scene for safety.
- Check the person’s responsiveness and breathing.
- Call emergency services and get an AED.
- Position the person on a firm, flat surface.
- Begin chest compressions.
- Give rescue breaths if trained and able.
- Continue CPR and follow the AED instructions until help arrives.
These steps describe general adult CPR. Children and infants require age-appropriate techniques.
Step 1: Check the Scene for Safety
Check the scene for hazards, such as traffic, fire, or electrical wires, before approaching the person to ensure it is safe to provide assistance.
If the scene is safe, approach the person and prepare to check for responsiveness. Use gloves or other protective equipment if readily available, but do not delay lifesaving care while searching for supplies.
Step 2: Check Responsiveness and Breathing
Tap the person’s shoulders and shout to see whether they respond. Look for normal breathing and check whether they are breathing only in occasional gasps.
Do not spend more than 10 seconds assessing breathing. Gasping is not normal breathing and may occur during cardiac arrest.
If the person is unresponsive and is not breathing normally or is only gasping, presume cardiac arrest and begin the emergency response. A lay rescuer should not delay CPR to check for a pulse.
Step 3: Call Emergency Services and Get an AED
Call 911, the local emergency number in the United States, or ask someone nearby to call. Have another person bring an automated external defibrillator (AED) if one is available.
If you are alone with an adult who has collapsed, call emergency services on speakerphone when possible and follow the dispatcher’s instructions.
An AED analyzes the heart’s rhythm and determines whether a shock is advised. Early defibrillation can improve the chance of survival for certain types of cardiac arrest.
Step 4: Position the Person Correctly
Carefully place the person on their back on a firm, flat surface. Kneel beside the chest so you can position your hands correctly and perform compressions effectively.
For an adult, place the heel of one hand in the center of the chest, on the lower half of the breastbone. Place your other hand on top and interlace your fingers.
Keep your shoulders directly above your hands and your elbows straight.
Step 5: Begin Chest Compressions
Chest compressions help circulate blood to the brain and other vital organs when the heart is not pumping effectively.
Follow these adult CPR compression guidelines:
- Hand placement: Center of the chest on the lower half of the breastbone.
- Compression rate: 100 to 120 compressions per minute.
- Compression depth: Compress the adult’s chest at least 2 inches (5 cm) but no more than 2.4 inches (6 cm) with each push.
- Chest recoil: Allow the chest to return fully to its normal position after each compression.
- Interruptions: Keep pauses as short as possible.
Push hard and fast, allowing the chest to rise fully between compressions. Avoid leaning on the chest between pushes.
If you are not trained in rescue breathing, or are unwilling or unable to give breaths, provide Hands-Only CPR for an adult who suddenly collapses. Continue chest compressions and follow the emergency dispatcher’s instructions.
Step 6: Give Rescue Breaths if Trained
If you are trained in conventional CPR and can give rescue breaths, use a ratio of 30 chest compressions to 2 breaths for adult CPR.
After 30 compressions:
- Open the airway by gently tilting the person’s head back and lifting their chin, unless their condition requires a different technique.
- Pinch the person’s nose closed.
- Create a seal over the person’s mouth with your mouth.
- Give one breath lasting about one second and watch for the chest to rise.
- Give a second breath, then immediately resume chest compressions.
Avoid giving breaths that are too forceful or too frequent. If the chest does not rise, reposition the airway and improve the seal before the next breath.
If you cannot provide rescue breaths, continue chest compressions rather than stopping CPR.
Step 7: Use an AED and Continue CPR
Use an AED as soon as it arrives. Turn it on, attach the pads to the person’s bare chest as shown, and follow the spoken or visual instructions.
Expose the person’s chest and attach the electrode pads according to the diagrams on the pads. Make sure nobody touches the person while the AED analyzes the heart rhythm or delivers a shock.
If the AED advises a shock, make sure no one is touching the person before delivering it. Immediately resume CPR after the shock or follow the AED’s instructions if no shock is advised.
Continue CPR until the person shows clear signs of life and begins breathing normally, trained emergency responders take over, the scene becomes unsafe, or you are physically unable to continue.
Are CPR Steps Different for Adults, Children, and Infants?
Yes, while CPR follows the same basic principles for adults, children, and infants, the techniques vary by age. All involve checking responsiveness, calling emergency services, and providing chest compressions. However, compression depth, hand placement, and rescue breathing techniques differ for each age group.
The following table highlights the key differences in CPR techniques for adults, children, and infants:
| CPR Guidelines | Adults | Children | Infants |
| Age group | Puberty and older | Age 1 to puberty | Younger than 1 year |
| Hand placement | Two hands on the center of the chest | One or two hands on the lower half of the breastbone | One hand heel or two-thumb encircling technique |
| Compression depth | At least 2 inches (5 cm), avoiding depths greater than 2.4 inches (6 cm) | About 2 inches (5 cm), or one third of chest depth | About 1.5 inches (4 cm), or one third of chest depth |
| Compression rate | 100 to 120 per minute | 100 to 120 per minute | 100 to 120 per minute |
| Compression-to-breath ratio for one rescuer | 30:2 | 30:2 | 30:2 |
| Compression-to-breath ratio for two trained healthcare rescuers | 30:2 | 15:2 | 15:2 |
| Rescue breaths | Give breaths if trained and able | Rescue breaths are particularly important | Rescue breaths are particularly important |
| AED use | Standard AED pads | Pediatric pads preferred when available | Pediatric pads preferred when available |
Note: CPR techniques follow current training guidelines. Newborn resuscitation follows a separate protocol. Always follow emergency dispatcher instructions and the AED’s prompts.
Should You Perform Hands-Only CPR or CPR With Rescue Breaths on an Adult?
Your CPR training level determines whether you should perform hands-only CPR or include rescue breaths.
If you are not trained in CPR or are uncomfortable giving rescue breaths, perform hands-only CPR by giving continuous chest compressions at a rate of 100 to 120 per minute.
However, if you are trained in CPR, perform conventional CPR using a 30:2 ratio. This means performing 30 chest compressions followed by 2 rescue breaths to maintain blood circulation and deliver oxygen to the person’s lungs.
What Are the Most Common CPR Mistakes?
Avoid these common errors when performing CPR on an adult:
- Waiting too long to call emergency services.
- Mistaking gasping for normal breathing.
- Placing the hands too high or too low on the chest.
- Performing compressions too slowly or too shallowly.
- Leaning on the chest instead of allowing full recoil.
- Taking long breaks between compression sets.
- Giving excessive or forceful rescue breaths.
- Delaying AED use after the device becomes available.
Regular CPR practice helps you avoid these common mistakes and perform CPR more effectively during an emergency. Taking an American Heart Association (AHA) CPR class through New York CPR Classes can help you build your CPR skills and confidence.
When Should You Stop CPR?
Stop CPR when the person shows signs of return of spontaneous circulation (ROSC), such as breathing normally or showing other signs of life, when emergency medical personnel take over, when the scene becomes unsafe, or when you are physically unable to continue.
Do not stop CPR just because several minutes have passed without a response. If another rescuer is available, switch roles about every two minutes to reduce fatigue and maintain effective chest compressions.
Build Your CPR Skills and Get Certified with New York CPR Classes
Reading about CPR helps you learn the steps, but hands-on practice teaches you how to perform chest compressions, give rescue breaths, and use an AED correctly. A CPR or Basic Life Support (BLS) course can help you develop these skills and practice responding to cardiac emergencies.
New York CPR Classes offers flexible American Heart Association (AHA) BLS, ACLS, and PALS courses at multiple locations throughout New York, so you can find a convenient training site nearby. Complete your online coursework and hands-on skills session, and receive your AHA provider eCard the same day you complete the required training.
Frequently Asked Questions About Adult CPR
What Is the First Step of Adult CPR?
The first step of adult CPR is to check the scene for safety, then assess the person’s responsiveness and breathing. If the person is unresponsive and not breathing normally, call 911 and begin CPR.
What Is the Correct Order for Performing CPR on Adults?
The correct order for adult CPR follows the C-A-B sequence: Compressions, Airway, and Breathing. First, check the person’s responsiveness and breathing. If they are unresponsive and not breathing normally, begin chest compressions, open the airway using the head-tilt/chin-lift technique, and give rescue breaths if trained.
How to Perform Adult CPR at Home?
If an adult collapses at home and is unresponsive and not breathing normally, call 911, put the phone on speaker, and begin CPR. Perform chest compressions at 100 to 120 per minute, give rescue breaths if trained, and use an AED if available.
Which Technique Should You Use When Giving Breaths to an Adult?
Use the mouth-to-mouth technique. Tilt the person’s head back, lift the chin, pinch the nose closed, and give two breaths, each lasting about one second, making sure the chest rises with each breath.
Why Does CPR Technique Vary by Age Group?
CPR techniques vary by age because infants, children, and adults have different body sizes and physical needs. These differences affect chest compression depth, hand placement, and rescue breathing techniques to ensure appropriate resuscitation.
